Page 3: Please fill in Debt Type & Total Amount of claim:

Please provide below detailed invoice related information:

Invoice details*

Add / Upload Invoice

Please note that the uploaded document should be in English language or translated in English which shall be accompanied with the original document. In case you wish the translation be done with us please upload the document and you will receive our quotation and if you agree you can continue with the application.)

Were invoices delivered to recipient? *

yes

no

Invoices properly stamped and signed by issuer?*

yes

no

Invoices signed by recipient? *

yes

no

Please provide below detailed agreement details:

Date of Agreement*

Place where the Agreement was signed:*

Governing jurisdiction (Country)*

Substantial terms of the Agreement:

Add / Upload

Please note that the uploaded document should be in English language or translated in English which shall be accompanied with the original document. In case you wish the translation be done with us please upload the document and you will receive our quotation and if you agree you can continue with the application.)

Please provide below detailed verbal agreement details:

Date of Agreement*

Governing jurisdiction (Country)*

Substantial terms of the Agreement:

Description of goods or services provided:

Description of terms of payment:

Did the debtor make any payments? *

yes

no

Date

Amount

Are there any guaranties in place?*

yes

no

Last date of contact/communication with debtor:

Were any attempts made or any steps taken to collect the amount due?*

yes

no

In which way?

Current status of this debt: *

Late Payment

Court Order

Did you take any legal actions against the debtor?*

yes

no

If Yes: Please give more info

Do you have any court order against the debtor? *

yes

no

Name of the court

(If Yes) Date of Judgment:

Case number:

Amount owned based on the Court order:

Are there any pending procedures/actions based/ or against the court order?*

yes

no

(if Yes) Please give more info: *

Upload any relevant documents for the above actions

Please note that the uploaded document should be in English language or translated in English which shall be accompanied with the original document. In case you wish the translation be done with us please upload the document and you will receive our quotation and if you agree you can continue with the application.

Last Page: Please mention any other details related to Business Activities of Debtors:

Business Activities*

Individual

Company

Debtor’s business activities:

Does the debtor have assets ?

Yes

No

Assets are ?

Movable

Immovable

Movable assets are

immovable assets are

Approximate turnover:

Number of Employees:

Have you ever cooperated in the past with the debtor ?

Yes

No

(If Yes): Provide details:

Was he consistent in his previous transactions?

Yes

No

Have you met him in person?

Yes

No

Debtor other business:

Other Companies to which Debtor or person related to Debtor is associate with/ linked to :

Please provide name and relationship:

Has the Debtor sold any assets within the period after the debt was incurred?

(Please note that the uploaded document should be in English language or translated in English which shall be accompanied with the original document. In case you wish the translation be done with us please upload the document and you will receive our quotation and if you agree you can continue with the application.)